Positive Change Through Praise, Play, and Rewards

Positive Change Through Praise, Play, and Rewards 

When discussing how to create positive behavior change in children one of the best places often to start is to examine the amount of positive interchanges occurring.  One area of psychological research that consistently produces similar findings is that when we look for happy kids, happy adults, happy couples, and happy employees what we find is that there are typically 5 positive interactions or examples for every 1 negative interaction or correction that occurs.  These numbers at times have been dropped to be a 3 to 1 ratio in workplace settings, but in general, when we have 5 positives to every 1 negative people typically report being happy in a relationship.

Given this research regarding the impact of having 5 positives to every 1 negative related specifically to parenting, it is no surprise that the best parenting books start with chapters on praise, play, and rewards/incentives.  It is common for parents to want to start by trying to solve current problems and address how to implement consequences.  However; in treatment or parent training it is typically better to start with praise, play, and rewards since then so many behavioral difficulties drop so significantly that consequences are needed so much less.  While it will always be important for families to have consistent ways in which they set healthy limits with children and enforce clear consequences, focusing on increasing positive interactions is definitely the place to start!

For parents looking for ways to bring positive change in this area I recommend several things:

1.  Take one week with the assignment to notice (possibly even documenting) all the things that your child is doing correctly.  We can get so caught up in the difficulties or behaviors that push our buttons it is easy to lose sight of all the positives and the many things that children are doing right.

2.  Take the following week to start praising your child for all the things that you are noticing.  This can be done through verbal praise such as, "Great job!  I really liked how you listened on the first time." or "Thanks for taking out the trash. I appreciate it."  Be aware and don't fall into the pitfall of combining a negative and a positive together such as, "Thanks for taking out the trash.  Too bad it took you so long."  Beyond verbal praise, high 5's and hugs can also communicate some of these positive sentiments.

3.  Take time to play or connect positively with your child everyday.  This could be through playing a game, watching a show together, reading together, talking to your child about his or her interests, etc.  Parents sometimes have to be mindful to pick activities that are likely to be positive versus negative.  For example:  for the scheduled play/connection time pick reading versus a board game if game time is often a time of contention in the household.

4.  Providing clear expectations with rewards for positive choices can also be a great way to improve the climate in a home and build in more positives.  List out behaviors in positive language for children and set children up for success in your reward plans.  Listing behaviors positively means stating an expectation as being "kind in words" versus saying "no disrespectful language."  Successful incentive plans often allow for children to do less initially to earn rewards while as time increases the desired expectations are raised for a child to reach the reward.

I cannot state strongly enough how important positive interactions with children are.  Working hard to achieve that 5 to 1 positive to negative ratio can be crucial in creating healthy family relationships and can work to bring about great behavior change in children.  While it can take real effort at first, especially if there have been a lot of negative interactions or challenging behaviors lately, these positive interactions will build healthy, happy children and families.

Making Changes Count and Last

Making Changes Count and Last

As the New Year starts and people are focusing energy on making resolutions it seems to be an appropriate time to write an article regarding how to be most successful with making healthy changes.  The process of how and why people change and what leads to lasting change has been a large emphasis of importance for the field of psychology.  The specific area of motivation to change has been an area of particular interest and study for myself personally in the field of mental health.

First, regarding motivation to change there is strong research in the field that has clearly defined stages that people commonly go through in their change process. Prochaska and DiClemente's Stages of Change Model describes a natural process in which people cycle through stages of readiness and action in the process of changing their behavior.  This cycle includes six stages:  precontemplation (person is not considering change), contemplation (person is considering change, but has not acted to make a change), preparation (person is getting ready to change and is surer that a change is needed), action (person implements changes), and maintenance (person is able to sustain change).  Relapse (stage 6) is also considered part of the process since most people re-cycle through the stages at least once on their way to stable change.  Relapse is generally an event that terminates the action or maintenance stages and leads the person to cycle back into the precontemplation or contemplation stages.

It can be important to keep a high level of motivation in order to stay in the action stage for change.  This can often be achieved by acknowledging both the pros and cons of a certain change since the pros of a change typically outweigh the cons.  For example: for someone deciding to eat healthier and exercise more the cons of this plan could be things such as it can be more expensive to eat healthy, takes more planning, can cause physical soreness, it is hard to give up some favorite unhealthy foods, etc.  This same person though when thinking of the pros or positives of healthier eating and exercise habits can focus on how he or she feels better when in better shape and eating healthy, the decreased risk for illness and chronic diseases, etc. Since these types of pros outweigh the cons that do exist the person can stay motivated and remain in the action phase of his or her change plan.  This type of strategy involving reviewing both the pros and cons also has been found to significantly help people maintain changes.

In addition, when people have made it through a motivation to change cycle and are in the action stage there are many things that assist people in being successful.  One key strategy is for people to set clear and realistic goals.  Setting both short-term and long-term goals can help people stay on track when creating new behaviors.  It also is critical for people to reward themselves with bonuses or incentives for reaching milestones along the way in achieving a goal.  Setting small, achievable goals and rewarding and celebrating successes is one of the best ways to stay encouraged and motivated to continue reaching a goal and moving into making a new behavior into a healthy habit.

Having significant support systems can also be crucial in successfully reaching goals.  In general, people who surround themselves with supportive others (often others with similar goals) are found to be successful.  For example, research has been presented that people who attend support groups for weight loss typically are more successful than others who try to reach their weight loss goals without a supportive system.

Sometimes people will try to change too many things at once, which for many people becomes too overwhelming.  This feeling of being overwhelmed often seems to lead to people becoming discouraged when they are not able to maintain all the changes they are trying at once.

The beginning of the New Year can offer a wonderful opportunity to reflect and reassess, creating the space to chart a course for change.  Hopefully some of this information regarding how the motivation to change process works, as well as strategies for how to set and achieve goals regarding creating new healthy habits will be helpful as people work to make changes this year.

**Prochaska, J. O. (1999). How do people change, and how can we change to help many more people?  In M. A. Hubble & B. L. Duncan (Eds.), The heart and soul of change: What works in therapy. (pp. 227-255). Washington, DC, USA: American Psychological Association.

Making the Most of the Holidays

Making the Most of the Holidays

For many families the holiday season can be both an exciting and stressful time of year.  This can be especially true for families with children with special needs who may struggle with some of the aspects of celebrating and participating in holiday events.  It can be particularly challenging for parents to make the most of the holidays in a way that doesn’t overwhelm them and their children.

The holiday season can be stressful for all children, especially children with special needs for many reasons.  Some of the challenges often presented this time of year include children being affected by a dramatic change in schedule, being overwhelmed by the amount of events that they are to attend, exposure to situations that can often aggravate sensitivities such as to touch, noise, and to various foods, struggling with being overexcited about events, and participating in family gatherings or traditions.  Attending family events can often be stressful for parents due to concerns regarding how their child might interact with other children and family members since often children with special needs struggle with emotion regulation and social skills.  This can be especially difficult when parents feel that other family members do not agree with their parenting in some situations since often parents of children with special needs have to provide interventions unique to their specific child.

The good news is that there are many strategies that can be helpful for families to truly make the most out of the holiday season for both parents and their children.  In general, it can be important to prepare children for what to expect and what will be expected from them as much as possible.  This could mean having many conversations about what is on the schedule for the day or week.  Often a visual reminder of what is coming can be helpful for children.  Parents can also benefit from being selective about what events they choose to have their children participate in and often limiting the number of events per day so that their child is less likely to be overwhelmed.  Allowing children to pick some of the activities that they will participate in and providing children with a lot of down time may also be important.  This may entail having large breaks in between events, but also may include bringing your child’s favorite toys or soothing things with them when you are out.  For example: having a stash of Legos that your child can play with in a quiet room at a holiday event for a specific period of time may be a lifesaver if your child is soothed by Legos.

For children with noise, touch, or food sensitivities it may make sense to try to avoid places that may be too stimulating for children.  For example: A parent may want to avoid holiday shopping with children at peak hours or during large mall events.  Parents can plan ahead and make sure to bring several of their child’s favorite snacks or foods to events as well.

Parents may also find that their children are more successful at family events if they provide a higher level of supervision and monitoring.  This higher level of monitoring can sometimes help children to navigate challenging social situations.  In many instances, parents may help stop a problem before it really starts.  For example: for children who struggle with playing board games with others, it may be helpful to pre-teach prior to the family event and provide incentives.  Pre-teaching could mean having a conversation prior to the day about how the child will likely be able to play a board game, and provide examples of how he or she can show good sportsmanship.  Incentives for good sportsmanship may also be helpful since children are often motivated by rewards.  Some parents will opt to bring a craft project or a noncompetitive game as a way to have their children participate in family events without having to compete if this would be too challenging at the current time for them.

Utilizing some of these strategies plus taking the time to think about a child’s unique needs and what types of things such as level of structure and reward plans usually help him or her to be successful can really help to make it a wonderful holiday season.  Being positive with children, creating opportunities for fun family times, and using some of these strategies that apply will hopefully help parents to create some great holiday memories.

Finding your Inner Sherlock Holmes

Finding your Inner Sherlock Holmes: Key Strategies for Being a Good Parent Detective

One of the keys to assisting children to grow and develop healthy is by providing the supervision and monitoring necessary to help them navigate the minefield around them that is otherwise known as the teen years. Research in the field consistently signals the importance of monitoring and supervision as main ways to help children be successful in these potentially turbulent years. Monitoring and supervision often include things such as knowing who children are spending time with, what they do when they are out of the home, where they go, and what the supervision, monitoring, and value systems are of their friends' parents. While some children are open books, other children do not want to include their parents in their lives or choices. For these children who often want more privacy and independence, parents often have to work hard, channeling their inner Sherlock Holmes to be the type of parent detective that their children need.

It is a parent's duty to know what his or her child is up to and that he or she is safe. This can be especially challenging for parents of children who want to be left alone to make their own choices and decisions. The responsibility remains with parents to know that their child is safe, by knowing what behaviors he or she is engaging in and what situations they may find him or herself in. For situations in which children do not share with their parents or include them, parents need to do what is necessary to get the information that they need.

There are several signs that may signify to a parent that their child may be struggling. These signs might include:
1.            A child has become withdrawn or secretive.
2.            A child's grades have decreased dramatically.
3.            Teachers, a child's friend, family members or others have brought up concerns for a child.
4.            A child has changed who they spend time with (possibly associating with others who may not be making healthy choices).
5.            A parent questions whether their child might be using drugs.
6.            Something in a parent's gut just tells him or her that something is not right!
 
What I advise parents to do is to trust their gut response. If something is telling them that something isn't right, they need to investigate and get the information needed to know if their child needs help to be safe. Sometimes parents get overwhelmed or discount their gut reactions thinking that they are overreacting. Without further information a parent may not know, and if his or her gut is right that a child may need a lot of support, guidance, and clear guidelines in order to be safe.
 
Parents can ascertain information in lots of ways. This can be as simple as being sensitive to children and asking questions. Sometimes parents find that asking children at the right times is crucial to get the information they need. I know of parents who make a point to get a special treat with their child or ask questions while driving alone together in the car because they have noticed that these are situations in which their specific child is more open. Another key is to be involved. Being involved in a child's life may include:
1.            Talk to other parents.
2.            Pay attention when you are driving a carpool-you might just be amazed about what children talk about when they don't think you are listening.
3.            Show up where your children are supposed to be. Often you will not even talk to them, but I recommend that you sometimes attend a movie at the same time or go buy a coffee when you know your child is supposed to be hanging out at a coffee shop or bookstore with friends.
4.            Have many clear rules for phones, computers, and social media. These rules should include things like no deleting or closing down any screens when you are in the room, that you can ask to see their pages, emails, texts, etc. at any time, and that you control all passwords. I know many parents who also have their own Facebook account or something similar just as a means to have more information about what his or her child is doing.
5.            Get clear evidence if possible. For example: if you are concerned about drug experimentation conduct drug testing.
 
Another challenge for parents is that many teenagers are upset and angry when their parents set rules, supervise, monitor, and when they investigate their child's behavior. I recommend that you notify children that it is your responsibility to be a good "parent detective" and that you take this job very seriously. It is OK to inform your children that it is your duty to keep them safe and healthy and that this is a nonnegotiable thing. Some parents also need to be firm and let their child know that he or she needs to comply with the parent's conditions in order to earn privileges. For example: many families have a rule that in order for a child to visit a friend the parent needs to have met that friend previously and spoke to the other child's parent about this specific event. If a child is not willing to comply with these guidelines than the child is told that he or she does not have permission and the matter won't be further discussed until he or she does what is necessary to fulfill the guidelines.
 
The best way is to get the information needed is to foster positive, open communication with your child. This is more likely to occur in cases where you make times to just have fun and positive interactions with your child, where you praise and reward your child for telling you things you think are important for you to know, and when you are able to manage your own emotions regarding what your child is telling you. Children are much more likely to discuss more important topics in the future when you have stayed calm and had good conversations about what they are telling you. It is a difficult balance, but it is important to hear your child out and also tell them your values as well as your hopes and dreams for them in a way that doesn't feel too much like a lecture. The reality is that children need their parents in these turbulent years and parents need to rise to the challenge. Know there are supports out there, good sources for education, other parents who also are working hard to keep their children safe who can be important allies, and parents have a wealth of knowledge because they survived their own teen years and have lived to tell about it. With all of this support and knowledge, parents can make Mr. Holmes proud.

Determining Whether an Assessment is Needed for your Child

Determining Whether an Assessment is Needed for your Child

There are many occasions in which a parent may want to have his or her child's learning assessed. Often psychoeducational assessments are conducted to determine if a child has a specific learning disability, significant attention difficulty, or mood disregulation. Assessment can be a powerful tool to learn more about a child's strengths and weaknesses and learning style.  Assessments also often provide a solid foundation to advocate for a child to receive various treatments and accommodations to help at school, home, and in the community.

A parent may want to consider having an assessment conducted for his or her child for several reasons including when the parent is concerned about various difficulties learning, achieving academically, behaving, or coping emotionally. In addition, teachers often express concerns that a thorough assessment may help to address.

A parent may want to consider an assessment if his or her child is having trouble learning including:
1)    Consistent difficulty in a specific subject area
2)    Not performing up to his or her ability across subjects
3)    Failing grades
4)    When there is danger of the child being retained
5)    Persistent difficulty despite additional academic support

An assessment may also be warranted if a child struggles in areas such as:
1)    Trouble paying attention/maintaining focus
2)    A parent questions a child's level of motivation due to trouble with homework struggles including homework time being a consistent source of conflict, a high number of missing assignments, incomplete work, or a child forgets to turn in work that was completed.
3)    A child has trouble sitting still for any significant length of time when it is not a favorite activity
4)    Trouble with organization
5)    Difficulties at school (with teachers or peers) due to impulsive behaviors such as talking at inappropriate times or saying or doing things without first thinking of the consequences of a behavior.
6)    Difficulties regulating emotions

An assessment may also be helpful for families in which there is a family history of learning or attention difficulties.

While the assessment process can take some time, conducting a comprehensive assessment can be one of the most important ways to support a child's growth.   Assessments make it possible to determine if a learning disability, attention difficulty, or mood disorder is impacting a child's learning, as well as provides information regarding a child's specific needs and often the most helpful ways to intervene.

Strategies to Help Children Overcome Social Challenges

Strategies to Help Children Overcome Social Challenges

Many children struggle socially.  This is especially true for children with attention, learning, and behavioral difficulties.  Certain behaviors common to ADHD can often negatively impact children socially.  These behaviors often include: acting impulsively, being insensitive to subtle interpersonal cues, having difficulty controlling what affects attention span, struggles learning from both positive and negative experiences, and trouble predicting audience response.[1]  Unfortunately, even when children with ADHD have friends, the friendships tend to be less supportive and more conflict-filled than those of children who do not struggle with attention difficulties.[2]

Parents play a vital role in assisting children with building their social competencies.  Several strategies that can be helpful include:
talking to your child about the importance of social skills
setting specific and realistic social goals
set up supervised, time-limited play dates for your child
review social goals prior to outings
choose simple and enticing play activities, involve teachers and other professionals in teaching your child social skills
prompt your child to think about the feelings and reactions of others.[3]

A great way to practice understanding the feelings and reactions of others is to stop movies or television shows and have your child guess what characters might be feeling, what social cues or body language they may be displaying, and to guess what might happen next.

Adding exciting bonuses for children practicing specific social skills can also be helpful.  For example: a child may receive a bonus at home for asking a peer a question during lunchtime at school.  Some children know exactly what to say to others and just need some prompting while other children desperately want friends but do not know what to say.  For children who struggle to know what to say to others an adult can practice conversations together.  Ping Pong Conversations is one of my favorite social skills games we play at camp in which children try to see how many times they can volley a conversation back and forth by asking questions and responding appropriately.  At Quest, we use this game as a way to have children practice skills including eye contact, turn taking, focusing on the other person’s perspective, practicing switching topics, etc.

Some tips for when you provide your child with friendship feedback are to keep it brief, be specific, stay focused on the present, and stay positive.[4]  I often think about the Charlie Brown cartoons in which any adult talking always sounds like “wha wha wha.”  Children with attention difficulties are typically more prone to hearing adults this way.  A large challenge for a parent or teacher can be to try and be concise and to the point by trying to give a child information in 10 words or less.  It can also be helpful to teach your child what to say in situations such as “If you lose you can say ‘good game’ to the winner”.[5]  It can also be helpful to praise and reinforce a child for what he or she did well versus focusing on what he or she did incorrectly in a social interchange.

Deep down social skill development takes time and children often benefit from getting to practice skills across a variety of settings and situations.  The good news is that positive adults can utilize a variety of strategies to assist children in building important skills in this area.



[1] Cohen, C. Raise your child’s social IQ. Attention, April 2010.
[2] Mikami, A. Y. How you can be a friendship coach for your child with ADHD. Attention, April 2010.
[3] Cohen, C. Raise your child’s social IQ. Attention, April 2010.
[4] Mikami, A. Y. How you can be a friendship coach for your child with ADHD. Attention, April 2010.
[5] Mikami, A. Y. How you can be a friendship coach for your child with ADHD. Attention, April 2010.

Taking the Emotion out of Parenting

Taking the Emotion out of Parenting

Parenting can easily be one of the most challenging aspects of a person's life.  While parenting can be an incredibly rewarding experience, there is no question that having to parent when a child is testing limits can be one of the most stressful and upsetting things for a parent to handle.  This can be especially true for parents of children with special needs since at times their children are more prone to high levels of emotional outbursts and challenging behaviors.  Luckily there are many strategies that can assist parents in staying calm no matter what situation arises with their child.

There are many strategies that can assist parents in staying calm despite their child's emotional or behavioral level.  These strategies can include:

1.  Pay close attention to your own emotion level by monitoring your mood and behaviors.  For example: If you can still talk calmly and feel positively about your child then you are probably still able to problem solve or provide appropriate discipline for your child.  If instead you are struggling to not raise your voice, threaten your child, provide unrealistic consequences, or are having trouble thinking clearly it is best to step away from your child to calm down.

2.  It is critical to notice what messages you are interpreting from your child to make sure that you are hearing them correctly.  Often when we are angry or upset we infer what others are thinking or feeling incorrectly.  This can often arise in parenting in cases when parents misinterpret their child saying "no" to them to instead mean, "You are a bad parent.  I don't care what you say.  I don't love you."  Parents often are able to manage their emotions better when they can frame their child saying "no" as "Right now my child is telling me that he or she needs a lot more guidance to make a correct choice."  It also can be really important to alter your child's message to what they really mean.  For example: It is crucial to re-frame when a child says something hurtful like, "I hate you." or "You are the meanest mom ever." to instead be, "I am so mad right now that I can't stand it."

3.  Walk away from the situation and calm down prior to trying to solve a situation with your child.  It is better to say, "I love you and I will work to solve this problem with you, but first I need to calm down" than to resort to a less effective and overly punitive approach.  It is also often helpful to tell your child, "You have earned a consequence for your behavior, but I am too mad to give it right now," as a way to acknowledge your child's behavior, but to also allow yourself room to avoid the pitfall of providing harsh consequences when angry.  

4.  Talk deep breaths, use imagery to think of a relaxing place, think positive thoughts, exercise, talk to a friend or spouse, read, or engage in other activities that will assist you in calming down and being ready to engage in healthy problem solving.  It is recommended that people engage in a minimum of 20 minutes per day of self-care as a way to manage stress and anxiety.

By removing some of the emotion related to parenting, parents often feel more in control and positive about their interactions with their child.  Give your child the benefit of the doubt in your communications with them and it is possible to feel happier and more effective as a parent.